One Day Last Month

My father is 94. Although  deaf and partially blind, his overall health has been good. For the past four years, he has lived at home receiving help from paid caregivers, until one day last month.

Dad had a very bad urinary tract infection that would not go away. It had begun to travel to his kidneys. He could not sleep because he constantly had to go. He didn’t want to wear diapers; it hurt his dignity. So, he struggled dozens of times to the bathroom about 10 steps from his bed. His caregivers and his family all worried that he would fall. Again.

My brother, who oversees his care day to day, told me he had to be hospitalized and that his caregiving team was very worried. But my brother had just moved into a new house, had a new job, and was finding it difficult to manage it all.

So, I flew to Colorado to help. Dad had only recently been approved for VA health benefits and was admitted to the Denver Veterans Administration hospital. His condition was “touch and go.” The young physician I first spoke to was at first puzzled, but said he and his team were hopeful. I was worried that he might be receiving substandard care, but I shouldn’t have been.

I was by Dad’s bedside for two days and I don’t recall there ever being a time when a nurse, nurse assistant or doctor wasn’t visiting. At one point, a team of physicians including the head resident stood in the room and explained in plain language just what was going on.

During one of those team consults, I told them that I had transcribed Dad’s South Pacific diary and it could be read online. Every single physician read it overnight. I recall that a few of the nurses did too. In other words, they took extra time to get to know my Dad; he was not just another number on a chart.

My brother, who has visited Dad in other nearby not-for-profit and for-profit hospitals over the past several years, said this was the most positive hospital experience he could recall. Rarely have doctors elsewhere spent the kind of time these folks had. Rarely has a team of nurses and nurse assistants been so attentive to his needs.

Dad began to recover; the doctors finally figured it out. However, since he would need a permanent catheter and round the clock care, the verdict was in. He would need long-term care in a facility; he could not return home. I was given a list of the homes the VA contracted with. Naturally, I expected the worst. But, once again, I was wrong.

With a few clicks of the mouse, I found not only an Eden Alternative home but one with stellar Nursing Home Compare ratings. It was 10 minutes from the VA hospital on a quiet city street adjacent to the city park. My brothers and I checked it out and Dad subsequently moved in.

Dad now eats with others in a common area, not alone in his apartment. He is able to walk the halls with his walker and an aide; at home, he rarely went for walks. His caregivers were concerned about his falling and their inability to pick him up. He is receiving speech therapy now, something he had trouble accessing at home through Medicare. His ex-wife and their dog can visit anytime.

So far so good. Dad seemed content the day before I had to return to Northern Virginia. He described his room, which is filled with sunlight most of the day and accommodates his furniture, artwork and family photos, as like a stateroom. This US Navy veteran of years at sea should know.

 

 

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Days of Rage Redux?

In 1970’s America there was a bombing somewhere in America almost every week. It was called Days of Rage. Now there are mass shootings that occur as often as that, but are far more shocking and frightening.

Yesterday, I went to the local post office. The shootings at San Bernadino were still in the headlines. The clerk and I spoke briefly about the shocking incident and I said on leaving, “Things are out of control.” To my surprise, that night on NBC Nightly News a parent of one of the victims said precisely the same thing.

I had forgotten about the Days of Rage. The bombings, when I heard or read about them, seemed distant and random. Somehow they seemed less frightening since the target was property not people. But, people did get killed and support of the Weather Undergound, if there had been any to begin with, soon disappeared.

Mass shootings are domestic terrorism, but with few exceptions seem unrelated to any consistent movement to change our society or political culture. They are random, but feel far less distant and far more frightening than the bombing of a university ROTC building or a city draft headquarters.

I remember when the Washington area was paralyzed by two mass shooters who shot innocent people randomly for weeks on end. My children’s school events were cancelled and we were even afraid to buy gas for fear the snipers would shoot us. For the first time, I knew then that it would be easy for anyone, from a foreign country or from within, to terrorize a city or the entire country. All they needed was a gun.

Today’s pundits and politicians  fear calling most mass shootings terrorism. Political leaders who send prayers to families of victims offer no solutions yet seem to get away with it.

People all over America should be angry, not just afraid. We should translate that anger into action to stop the plague of gun violence. We should challenge those who would rather pray than act. We must confront the gun power structure that holds America hostage and should be blamed for the deaths of far too many innocents.

 

 

 

 

 

 

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Loonies of the Right

The Capitol Steps, a riotous comedy troupe based in DC, coined this phrase and use it in a song to the tune of “Music of the Night” from Phantom of the Opera. And, it has been swirling around in my head for the past few days as the roads here empty and federal employees in my neighborhood are forced to stay at home and can only guess when they next get paid.

The mean-spirited, harsh words of Republican members of Congress for government employees is beyond comprehension. The video footage of a member berating a Park Service employee for doing their job when it is because of him and other Congressional radicals like him that other employees are not getting paid is truly sickening. These people have no shame.

Worse, their tactics mean millions of children and elderly will not receive meals for weeks and, if this goes on, Social Security and Medicare could grind to a halt. But, to these people who seem to be taking pages out of the Brownshirt playbook, it’s what they wanted all along.

The Loonies of the Right are too dangerous to be funny anymore. Even with the Republican’s brilliant gerrymandering and voter suppression efforts, one only can hope that their constituents are smart enough to see through their insane behavior and send people who are willing and able to govern.

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Cut Medicare? Cut Medicaid? Why?

In the 1980s, I worked for a health economist named Carl Schramm. His mantra was that the real problem was health care costs, not the cost of insurance. This message landed him a great job with the health insurance industry and he played it forward while leading its lobbying group in the prelude to the Clinton’s health reform efforts.

While I get that health insurers would rather blame providers (hospitals and doctors at that time more than pharmaceutical companies) rather than shoulder the blame for ever-increasing costs, policymakers might want to think about what Schramm was trying to get across nearly 25 years ago.

Here’s my favorite example. In 2006, a Republican-led effort added a prescription drug benefit to  Medicare. The law specifically states that Medicare could not negotiate prices (it was reasoned the market will do that and how is that working exactly?).

Before tearing up the social contract with older Americans and throwing in the towel, let’s empower Medicare and Medicaid to negotiate health care costs across the board. Giving them more control over costs might, just might save these crucial programs for future generations.

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What is Their Vision?

The photo of armed Tea Party members standing in front of the Montana state capitol is chilling and a stark reminder of the insanity of our gun laws, but what is it that these folks really want? What is their real vision for America?

Here are some logical conclusions based on the rantings of many who say they belong to this far right movement:

A nation in which:

  • The elderly are left to starve on the street
  • Teachers are paid as little as possible
  • Health care is a privilege only available to the few
  • Unions have disappeared
  • The federal courts are subservient to corporate interests
  • There are as many tanks and aircraft engines as our money can buy
  • Anyone can walk into a church, school or bar armed to the teeth
  • The rich can get richer, while millions of America’s children go to bed hungry
  • Only “real” Americans can be President

Now that’s just the kind of country that anyone would want to live in.

Montana Tea Party Bring Guns to State Capitol

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Health Reform and Secession

I live in Virginia. My attorney general has challenged the legality of the new federal health reform law and a US District Judge appointed by former President Bush gave his case the green light this week.

The AG’s case is based on a state’ rights issue that reminds me eerily of why the United States had a bloody and obviously inconclusive civil war.  He and those like him believe the federal government does not have the power to enact a law that the attorney general (and his Tea Party friends) do not like.

I actually live in what I’m sure those from Richmond south call the People’s Republic of Northern Virginia. I can tell you that many people here do talk of seceding, but from the Commonwealth of Virginia not the United States of America.

For most of my adult life I have been an advocate for older Americans. But I have also been a vocal proponent of health care reform for more than 30 years. To me what passed is a generous gift to the private  health insurance industry allowing them to reap enormous future profits. This law is hardly socialism.

And, yes it does punish those companies a bit, taking away an enormous subsidy for running Medicare Advantage Plans at taxpayer expense (saving us all a pretty penny). But, the law adds new benefits to Medicare and plugs the donut hole in Medicare prescription drug coverage.

This attorney general is ethically challenged. He would rather see families go broke because they can’t afford health coverage or have a son with cancer requiring $100,000 a year go bankrupt. He would rather see me pick up the tab for the care of people who crowd emergency rooms and have no coverage at all (it’s called cost shifting but that’s a long story).

I wonder if Arlington would be our state capitol. Or, maybe Manassas would be more appropriate.

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Cutting Social Security Will Hurt Low Income Elders

The poll results announced yesterday by the National Committee to Preserve Social Security and Medicare should make members of Congress and others who want to make drastic changes to Social Security think twice.

Proposals to significantly cut benefits or raise the retirement age would hurt older adults with limited income and resources disproportionately. The poll clearly shows that the American people oppose those types of changes.

With the 75th anniversary of Social Security just around the corner, it’s time to strengthen Social Security and not make the most vulnerable in our society suffer.

The poll “U.S. Attitudes Toward Social Security” is now available on the National Committee Foundation’s website.

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